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Individual

JAMES W JESSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1805 HENNEPIN AVE N, GLENCOE, MN 55336-1416
(320) 864-3121
Mailing address
1805 HENNEPIN AVE N, GLENCOE, MN 55336-1416
(320) 864-3121

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27606
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0114591
MEDICA
MN
01
115267
UCARE
MN
01
2178707
AMERICAS PPO
MN
01
41084933956001C037
CHAMPUS
01
41375JE
BCBS
MN
05
933772500
MN
01
HP21619
HEALTH PARTNERS
MN
01
NA2951011066
PREFFERED ONE
MN
01
P0010642
RR MEDICARE
Enumeration date
01/09/2006
Last updated
11/14/2019
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